Commonwealth of Virginia CSA Conference

April 20, 2015

Amy Atkinson

Leah Mills

COMMONWEALTH OF VIRGINIA

Commission on Youth

The Use of Federal, State, and Local Funds for Private Educational Placements of

Students with Disabilities – Breakout Session

Virginia Commission on Youth

Background The Commission on Youth is a standing legislative commission

of the Virginia General Assembly.

It was established in statute, §30-174 and §30-175, by the 1989 General Assembly.

It provides a legislative forum in which complex issues related to Virginia youth and their families can be explored and resolved.

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Virginia Commission on Youth

Role Virginia Code§30-174 states that the Commission shall “study and

provide recommendations addressing the needs of and services to the Commonwealth’s youth and families.” The Commission’s primary areas of concern are:

–Child Welfare –Education –Child Health –Child Mental Health –Juvenile Justice The Commission conducts its studies through research and data

analysis, generally with guidance from Advisory Groups providing subject expertise.

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Virginia Commission on Youth

Delegate Christopher K. Peace, Chair Delegate Richard L. Anderson Delegate Mamye E. BaCote Delegate Richard P. Bell Delegate Peter F. Farrell Delegate Mark Keam

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Senator Barbara A. Favola, Vice-Chair Senator Dave W. Marsden Senator Stephen H. Martin Deirdre Goldsmith Frank Royal, M.D. Charles Slemp, III, Esq.

Membership

The Commission is composed of six delegates, three senators and three citizens appointed by the Governor.

Virginia Commission on Youth

2014 Studies and Initiatives Early Childhood Education – Workgroup on Quality

Use of Restraint and Seclusion in Schools

Court-Appointed Attorneys in Child Welfare Cases

Unlawful Adoption of a Child

Three Branch Institute on Child Social and Emotional Well-Being (Year Two)

Collection of Evidence-based Practices for Children and Adolescents with Mental Health Treatment Needs (Biennial Update)

The Use of Federal, State, and Local Funds for the Private Educational Placements of Students with Disabilities (Year One)

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Virginia Commission on Youth

2015 Studies and Initiatives Evidence-based Practices for Children and Adolescents

with Mental Health Treatment Needs (Biennial Update)

Temporary Placements of Children

Implementation of School Divisions’ Concussion Policies

The Use of Federal, State, and Local Funds for the Private Educational Placements of Students with Disabilities (Year Two)

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The Use of Federal, State, and Local Funds for Private Educational

Placements of Students with Disabilities Year 2

Virginia Commission on Youth

Study Mandate

HJR 196 (Adams) directs the Commission on Youth (COY) to: ‒ examine the use of Comprehensive Services Act for At-Risk Youth and

Families (CSA) and Medicaid funds for private day and private residential special education placements;

‒ gather local and statewide data when youth are placed in these placements;

‒ determine the feasibility and cost-effectiveness of more integrated alternatives to provide special education services to students including students with intellectual and developmental disabilities currently in segregated settings; and

‒ consider any other matters appropriate to meet the objectives of this study.

COY is to complete its meetings by 11/14 the first year and by 11/15 the second year and report recommendations prior to the 2016 General Assembly Session.

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Identified Issues

Special education, pursuant to the Individuals with Disabilities Education Act (IDEA), is specially designed instruction provided at no cost to the parents in order to meet the unique needs of a child with a disability.

IDEA guarantees a free appropriate public education (FAPE) to all eligible children with disabilities including: ‒ identification and referral, ‒ evaluation, ‒ determination of eligibility, ‒ development of an individualized education program (IEP), ‒ determination of services, and ‒ reevaluation.

IDEA requires that students be provided special education services in the least restrictive environment (LRE) and that students with an Individualized Educational Program (IEP) not be unnecessarily segregated from nondisabled students, including those receiving educational services in private day and private residential schools or facilities.

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Identified Issues (cont.)

State general funds support special education services in public school settings.

Medicaid funds may be utilized to support private residential placements, but only for those youth with mental health treatment needs that qualify for residential services.

CSA funds may also be used to provide services for at-risk youth and their families, including private day school and residential placements for the purposes of special education. Local interagency teams are responsible for managing CSA funds and also plan and oversee services to youth.

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Commonly Used Terms – Special Education

IDEA – Individuals with Disabilities Education Act

IEP – Individualized Education Program

LRE – Least Restrictive Environment

FAPE – Free Appropriate Public Education

11 Source: Virginia Department of Education. (September 16, 2014). Fundamentals of Special Education. Presentation to the Virginia Commission on Youth.

Commonly Used Terms – CSA

CSA – Comprehensive Services Act for At-Risk Youth and Families

SEC – State Executive Council

SLAT – State and Local Advisory Team

CPMT – Community Policy and Management Team

FAPT – Family Assessment and Planning Team

MDT – Multi-Disciplinary Team

12 Source: Virginia Department of Education. (September 16, 2014). Fundamentals of Special Education. Presentation to the Virginia

Commission on Youth.

Federal & State Laws/Regulations/Policy

Individuals with Disabilities Education Improvement Act of 2004 (IDEA) 20 U.S.C. §1400 et seq. and associated regulations 34 C.F.R. §300.1 et seq.

Virginia Code §22.1 Article 2. Special Education

Virginia Code §2.2 – 5211. Comprehensive Services Act for At-Risk Youth and Families. State pool of funds for community policy and management teams

8 VAC 20 Chapter 81 – Regulations Governing Special Education Programs for Children with Disabilities in Virginia (effective 1/10/10)

Comprehensive Services Act for At-Risk Youth Policy Manual

13 Source: Virginia Department of Education. (September 16, 2014). Fundamentals of Special Education. Presentation to the Virginia Commission on Youth & Office of Comprehensive Services Website (2014).

FAPE & LRE

IDEA requires schools to provide FAPE in the LRE to students with disabilities. IDEA defines LRE as follows: – To the maximum extent appropriate, children with disabilities,

including children in public or private institutions or other care facilities, are educated with children who are not disabled, and special classes, separate schooling, or other removal of children with disabilities from the regular educational environment occurs only when the nature or severity of the disability of a child is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily.

Source: IDEA, 20 U.S.C.§1412 (a)(5)(A).

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Defining LRE

Continuum of Alternative Placements

Source: Virginia Department of Education. (2011). Guidance Document on Standards-Based Individualized Education Program (IEP). 15

Regular Classes Special Classes Special Schools Student’s Home Hospital or Institution

Least Restrictive Most Restrictive

Special Education Child Count

Special Education Child Count for Commonwealth of Virginia for 2013-2014

16 Source: Virginia Department of Education, 2014.

Disability Code Grade PK Grade KG Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 TotalAutism 825 877 1089 1299 1414 1392 1371 1290 1217 1154 1036 887 818 1190 15859Deaf- Blindness 32Developmental Delay 6750 2906 1326 10982

Emtionally Disturbed 48 161 317 495 582 674 773 862 995 1191 1083 917 948 9051

Hearing Impairment 131 93 114 111 93 113 99 94 86 103 100 86 82 99 1404Intellectual Disabilties 42 201 367 450 562 608 645 734 790 783 871 784 815 1568 9220

Multiple Disabilities 146 132 173 199 227 229 238 214 260 268 284 253 295 482 3400Other Health Impairments 157 387 1079 1827 2331 2732 2810 2902 2917 2878 3298 2807 2443 2438 31006

Orthopedic Impairment 70 56 58 66 65 46 50 62 41 47 48 60 69 46 784

Specific Learning Disability 10 169 879 2108 3337 4609 5317 5663 5650 5695 6187 5304 4486 4616 54030

Speech/Language impairment 3503 3557 4558 4017 3070 2299 1604 935 585 392 199 143 100 78 25040

Traumatic Brain Injury 18 11 11 11 20 28 31 29 28 45 37 40 46 64 419

Visual Impairment 32 30 49 33 46 45 57 49 45 46 50 38 31 41 592161819

Virginia’s LRE Targets

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State Performance

State Target

Performance Met?

Students included in regular classroom 80% or more of the day

62.2% 68% No

Students included in regular classroom less than 40% of the day

12.6% <8% No

Students served in separate public or private school, residential, home-based or hospital facility

3.6% <1% No

Source: Virginia’s Annual Performance Report 2012-2013.

LRE for School Age Students for 2012 to 2013 – Virginia Department of Education

Special Education Services Under CSA CSA is a law enacted in 1993 that was created to meet the needs of

families with children and youth who have, or who are at risk of having, serious emotional or behavioral difficulties.

CSA establishes a single state pool of funds to purchase services for at risk youth and their families. The state funds, combined with local community funds, are managed by local interagency teams who plan and oversee services provided to youth.

Youth for whom services are mandated by law fall into 2 groups : – Youth in foster care and those deemed to be imminently at-risk for

placement into foster care. – Youth who are special education eligible and have an IEP requiring they

receive education in a private day or residential school setting.

18 Source: Office of Comprehensive Services. (2014). For Parents. [Online]. http://www.csa.virginia.gov/html/for_parents/for_parents.cfm. (October 2014).

CSA & Special Education Targeted Population

The special education target population includes those "children placed for purposes of special education in approved private school educational programs, previously funded by the Department of Education through private tuition assistance."

This includes all children with IEP's requiring placements in private day school or private residential facilities.

19 Source: Va. Code §2.2-5211.

Funding Special Education Services

20 Source: Office of Comprehensive Services. (2014). Comprehensive Services Act Serving Children Through Public-Private Partnerships. Presentation at the VAISEF 2014 Spring Conference.

LRE on IEP is public school

placement

Local school division funds all

IEP services

LRE on IEP is private school

placement

CSA funds all IEP services

(except transportation)

School Division Responsibilities

Conducts evaluations for eligibility Ensures IEPs are implemented (public & private) Pays for:

‒ IEP services and supports (public school); ‒ Homebound services; ‒ Regional special education programs; ‒ Tuition to another public school; and ‒ Transportation to implement IEP (private setting).

21 Source: Virginia Department of Education. (March 25, 2014). What CSA Personnel Need to Know About Special Education. Presentation to the Comprehensive Services Act Conference.

CSA Responsibilities

When IEP calls for private day or residential, CPMT/FAPT/MDT will: ‒ authorize funding/payment; ‒ collect required data for reporting; ‒ consider needs of child/family beyond IEP; ‒ collect data for utilization review; ‒ assures coordination of services; and ‒ not request/suggest modifications to IEP.

22 Source: Virginia Department of Education. (March 25, 2014). What CSA Personnel Need to Know About Special Education. Presentation to the Comprehensive Services Act Conference.

Special Education Services Under CSA CSA policies and procedures may not interfere/impede the

delivery of services in accordance with IDEA. Local policies/procedures vary. CPMTs cannot deny funding of a private day or residential

placement included in a student’s IEP. ‒ When an IEP team determines that there are multiple providers that

can implement a child’s IEP, the selection of provider may be governed by requirements established by the CPMT.

‒ However, if a child’s IEP names a specific provider of services and/or if the IEP team determines that a single provider is uniquely able to implement the child’s IEP, that provider must be utilized regardless of its status relative to licensure, contracting, CPMT approval, etc.

23 Source: Virginia Department of Education. (2011). CSA and Special Education Frequently Asked Questions.

Special Education Services Under CSA

24 Source: Office of Comprehensive Services. (2013). Special Education Services under the CSA, Annual Report to the General Assembly.

$34,000

$35,000

$36,000

$37,000

$38,000

$39,000

$40,000

FY 11FY 12

FY 13

$36,175

$38,630

$39,627

Annual Average Expenditure Per Child – Special Education Services By Fiscal Year

Special Education Services Under CSA

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$0

$10,000,000

$20,000,000

$30,000,000

$40,000,000

$50,000,000

$60,000,000

$70,000,000

$80,000,000

$90,000,000

FY 11FY 12

FY 13

Private Day School

Residential Program(Medicaid)

Residential Program (Non-Medicaid)

Source: Office of Comprehensive Services. (2013). Special Education Services under the CSA, Annual Report to the General Assembly.

Net Expenditures by Placement Type – Special Education Services by Fiscal Year

FY 11 FY 12 FY 13Private Day School $79,919,258 $78,724,431 $85,521,889 Residential Program (Medicaid)

$5,238,511 $5,783,148 $6,439,138

Residential Program (Non-Medicaid)

$9,266,474 $9,746,140 $9,263,610

Special Education Services Under CSA

26 Source: Office of Comprehensive Services. (2013). Special Education Services under the CSA, Annual Report to the General Assembly.

Number of Youth Served by Placement Type – Special Education Services by Fiscal Year

0 500 1,000 1,500 2,000 2,500

FY 11

FY 12

FY 13

2,275

2,257

2,342

191

220

225

139

147

133

Residential Program (Non-Medicaid)Residential Program(Medicaid)Private Day School

Special Education Services Under CSA

27 Source: Office of Comprehensive Services. (2013). Special Education Services under the CSA, Annual Report to the General Assembly.

Average Cost Per Child by Placement Type By Fiscal Year

$0

$50

$100

$150

$200

$250

$300

$350

FY 11 FY 12 FY 13

$114 $124 $130 $121 $113 $119

$291 $300 $321

Private Day School

Residential Program(Medicaid)Residential Program (Non-Medicaid)

Special Education Services Under CSA

28 Source: Office of Comprehensive Services. (2013). Special Education Services under the CSA, Annual Report to the General Assembly.

Average Length of Stay (# of Days) by Placement Type by Fiscal Year

0 50 100 150 200 250 300

FY 11

FY 12

FY 13

282

281

282

228

232

241

229

221

217

Residential Program (Non-Medicaid)Residential Program (Medicaid)

Private Day School

Study Activities (Year One & Two) Conduct extensive background and literature reviews on other states’

initiatives and policies Review federal statutes and regulations

‒ Individuals with Disabilities in Education Act of 2004 (IDEA) ‒ IDEA federal regulations

Review Virginia laws and regulations ‒ The Comprehensive Services Act for At-Risk Youth and Families ‒ Virginia’s Special Education Regulations

Review Comprehensive Services Act Policies ‒ Local match rate allocations ‒ Utilization of Medicaid for Special Education Services ‒ CSA Reimbursement for Wraparound educational services

Meet with state and local officials, as well as key stakeholders Collect data to review the use of special education placements funded by

CSA Number of children who are placed Services recommended Service gaps

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Study Activities (Year Two) Convene Advisory Group

‒ Comprehensive Services Act for At-Risk Youth ‒ Virginia Department of Education ‒ Department of Behavioral Health and Developmental Services ‒ Virginia Board for People with Disabilities ‒ Local Education Agencies ‒ Community Policy and Management Teams Representatives ‒ Family Assessment and Planning Team Representatives ‒ Virginia Association of Independent Specialized Education Facilities ‒ Virginia’s Parent Resource Centers ‒ Partnership for People with Disabilities ‒ Clinicians and School Psychologists ‒ Other Advocacy Organizations ‒ Local Education Agencies/Special Education Administrators/Educators ‒ Family Members/Youth

Compile a description of services provided in private day/residential facilities not available within local school divisions

Determine the feasibility and cost-effectiveness of more integrated alternatives Present findings and recommendations to COY

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Study Activities (Year Two) Review other CSA legislation HB 221 (Bell) – Students; admission to certain children’s residential facilities. Left in

Appropriations. Requires each student admitted under a physician's order, due to medical necessity and not solely for school purposes, to a children's residential facility to immediately be enrolled in an education program that is comparable to that which is provided in the child's school division of residence. Relevant issues to be addressed by HJR 196.

HB 229 (Cole) – Comprehensive Services for At-Risk Youth and Families; Special Education Programs. Expands eligibility for services to students who transfer from an approved private school special education program to a public school special education program. Left in Appropriations.

SB 153 (Stuart) – Comprehensive Services for At-Risk Youth and Families; Special Education Programs. Companion to HB 229. Left in Appropriations.

SB 369 (Favola) – Membership of the SEC. Would add a third private provider representative, a representative of a child advocacy group or organization, a representative of a mental health advocacy group with a specialization in children's mental health, and a representative of a public provider of children's mental health services. Left in Health, Welfare and Institutions.

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Study Activities (Year Two)

Monitor activities of SEC and SLAT Subgroup of SEC reviewing non-CSA residential

placements and funding educational services

Data Element/Service Name Standardization Efforts

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Questions/Comments? Amy Atkinson, Executive Director

Leah D. Mills, Senior Policy Analyst Virginia Commission on Youth

804-371-2481 aatkinson@vcoy.virginia.gov

lmills@vcoy.virginia.gov http://vcoy.virginia.gov

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